PROJECT SUMMARY - OVERALL The target population for this ALACRITY center is people diagnosed with schizophrenia, who commonly have impaired social and occupational functioning, experience persistent psychotic and mood symptoms, and are at risk for disability and premature death. We named this proposed center OPAL, after its goal of Optimizing and Personalizing interventions for people with schizophrenia Across the Lifespan. The goal of OPAL is to accelerate the adaptation, development and implementation of effective, personalized treatments in real-world settings. The specific aims of this center are as follows: 1. Create an infrastructure that supports research that tests innovative ways to optimize treatments for people with schizophrenia throughout the lifespan and that accelerates the translation of clinical research on schizophrenia to routine practice settings. 2. Conduct exploratory and pilot projects that develop, adapt, and test innovative methods to personalize treatments for schizophrenia and to make them effective and readily deployable. 3. Train scientists who will conduct translational research on services and treatments for persons with schizophrenia. The three OPAL developmental projects address important representative problems that affect people diagnosed with schizophrenia throughout the course of illness. Project 1 addresses cognitive impairments, which have been detected during the prodromal period until late life and are a key contributor to functional impairments. The project examines ways to personalize cognitive remediation and make it more accessible. The project will examine the feasibility of delivering cognitive remediation in non-clinic settings and baseline testing to tailor the intervention to individual needs. Project 2 addresses the treatment of common chronic medical conditions that are associated with considerable morbidity and premature mortality in schizophrenia. The project adapts Critical Time Intervention (CTI) to the needs of individuals with schizophrenia who are hospitalized for ambulatory care sensitive conditions and examines its preliminary effectiveness. Project 3 focuses on psychotropic medications, which are vital but poorly deployed treatments for schizophrenia. The project examines the feasibility and effectiveness of using mobile health technology and Experience Sampling Methods (ESM) to optimize psychopharmacologic regimens for individuals with first-episode psychosis. The OPAL Center will use common resources and methodologies to improve the implementation and personalization of treatments. As a complement to the quantitative data gathered in each project, we will use qualitative methods to get stakeholder input, particularly on techniques to maximize engagement in treatment, and to refine and adapt interventions for effective implementation in real-world settings.